title: The natural history of children with severe combined immunodeficiency: baseline features of the first fifty patients of the primary immune deficiency treatment consortium prospective study 6901.
abstract: The Primary Immune Deficiency Treatment Consortium (PIDTC) consists of 33 centers in North America. We hypothesized that the analysis of uniform data on patients with severe combined immunodeficiency (SCID) enrolled in a prospective protocol will identify variables that contribute to optimal outcomes following treatment. We report baseline clinical, immunologic, and genetic features of the first 50 patients enrolled, and the initial therapies administered, reflecting current practice in the diagnosis and treatment of both typical (n = 37) and atypical forms (n = 13) of SCID. From August 2010 to May 2012, patients with suspected SCID underwent evaluation and therapy per local center practices. Diagnostic information was reviewed by the PIDTC eligibility review panel, and hematopoietic cell transplantation (HCT) details were obtained from the Center for International Blood and Marrow Transplant Research. Most patients (92 %) had mutations in a known SCID gene. Half of the patients were diagnosed by newborn screening or family history, were younger than those diagnosed by clinical signs (median 15 vs. 181 days; P = <0.0001), and went to HCT at a median of 67 days vs. 214 days of life (P = <0.0001). Most patients (92 %) were treated with HCT within 1-2 months of diagnosis. Three patients were treated with gene therapy and 1 with enzyme replacement. The PIDTC plans to enroll over 250 such patients and analyze short and long-term outcomes for factors beneficial or deleterious to survival, clinical outcome, and T- and B-cell reconstitution, and which biomarkers are predictive of these outcomes.
authors.affiliation: Division of Pediatric Allergy, Immunology, and Bone Marrow Transplant, Benioff Children's Hospital, University of California San Francisco, 505 Parnassus Ave., M-659, San Francisco, CA, 94143-1278, USA, dvorakc@peds.ucsf.edu.
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Dvorak
authors.forename: Morton J
authors.initials: MJ
authors.lastname: Cowan
authors.forename: Brent R
authors.initials: BR
authors.lastname: Logan
authors.forename: Luigi D
authors.initials: LD
authors.lastname: Notarangelo
authors.forename: Linda M
authors.initials: LM
authors.lastname: Griffith
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Puck
authors.forename: Donald B
authors.initials: DB
authors.lastname: Kohn
authors.forename: William T
authors.initials: WT
authors.lastname: Shearer
authors.forename: Richard J
authors.initials: RJ
authors.lastname: O'Reilly
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Fleisher
authors.forename: Sung-Yun
authors.initials: SY
authors.lastname: Pai
authors.forename: I Celine
authors.initials: IC
authors.lastname: Hanson
authors.forename: Michael A
authors.initials: MA
authors.lastname: Pulsipher
authors.forename: Ramsay
authors.initials: R
authors.lastname: Fuleihan
authors.forename: Alexandra
authors.initials: A
authors.lastname: Filipovich
authors.forename: Frederick
authors.initials: F
authors.lastname: Goldman
authors.forename: Neena
authors.initials: N
authors.lastname: Kapoor
authors.forename: Trudy
authors.initials: T
authors.lastname: Small
authors.forename: Angela
authors.initials: A
authors.lastname: Smith
authors.forename: Ka-Wah
authors.initials: KW
authors.lastname: Chan
authors.forename: Geoff
authors.initials: G
authors.lastname: Cuvelier
authors.forename: Jennifer
authors.initials: J
authors.lastname: Heimall
authors.forename: Alan
authors.initials: A
authors.lastname: Knutsen
authors.forename: Brett
authors.initials: B
authors.lastname: Loechelt
authors.forename: Theodore
authors.initials: T
authors.lastname: Moore
authors.forename: Rebecca H
authors.initials: RH
authors.lastname: Buckley
mesh_terms: D015415:Biomarkers / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005820:Genetic Testing; D005838:Genotype; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D016130:Immunophenotyping; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies; D016511:Severe Combined Immunodeficiency / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers